| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNETT INSURANCE AGENCY3 | 3447 LAWRENCEVILLE-SUWANEE ROAD SUWANEE, GA 30024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | — | $11K | 9.92% |
| BURNETTE INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE ROAD SUWANEE, GA 30024 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| BURNETT INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE ROAD SUWANEE, GA 30024 | LINCOLN NATIONAL LIFE INSURANCE CO. | $4K | — | $4K | 10.44% |
| BURNETT INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE ROAD SUWANEE, GA 30024 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.12% |
| BURNETT INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE ROAD SUWANEE, GA 30024 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO | $1K | — | $1K | 9.97% |
| BURNETTE INSURANCE AGENCY3 Filed as: BURNETTE INSURANCE AGENCY, INC. | 3447 LAWRENCEVILLE-SUWANEE ROAD SUWANEE, GA 30024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $684 | $173 | $857 | 8.54% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, INC. | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $231 | $30 | $261 | 2.60% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $215 | $37 | $252 | 2.51% |
| SHERI L MITCHELL INC3 Filed as: SHERI L MITCHELL LLC | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $185 | $8 | $193 | 1.92% |
| C ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $99 | $15 | $114 | 1.14% |
| KYLE RUSSEY3 | 6921 E. WEDGEWOOD AVE. DAVIE, FL 33331 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $18 | $50 | 0.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER & CO. | P. O. BOX 70 WEST POINT, GA 31833 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.49% |
| MARSH & MCLENNAN AGENCY LLC3 | P. O. BOX 70 WEST POINT, GA 31833 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.44% |
| PLM SOLUTIONS INC3 Filed as: PLM SOLUTIONS, INC. | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.22% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.14% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.13% |
| TULLY AND COMPANY INC3 Filed as: TULLY AND COMPANY LLC | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.10% |
| CAROLE H WARREN3 | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.06% |
| BURNETTE INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE ROAD SUWANEE, GA 30024 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $950 | — | $950 | 15.01% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 108 | $114K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 108 | $114K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO | 223 | $13K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $24K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE CO. | 105 | $37K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 197 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.